Pono anei kahi ʻoki e wehe i nā ʻōpū colon? E aʻo kākou e pili ana i ka Endoscopic Submucosal Dissection (ESD)!

Ua haʻi aku ke kauka iā ʻoe he puʻupuʻu liʻiliʻi kou i loko o kou kolona a i ʻole ka esophagus e pono e wehe ʻia? Ke lohe ʻoe i kēlā, nui ka poʻe o mākou e makaʻu a hopohopo, me ka noʻonoʻo ʻana, "Auē, pono anei iaʻu ke hana i kahi ʻoki nui?" Akā me ka ʻenehana lapaʻau holomua i loaʻa i kēia lā, aia nā ala kupaianaha e wehe ai i kēia mau mea me ka ʻole o ka hana ʻana i kahi ʻoki nui i ke kino. I kēia lā, e kamaʻilio mākou e pili ana i kekahi ʻano lapaʻau kūikawā, minimally invasive.

I ka ʻōlelo maʻalahi, he aha ka Endoscopic Submucosal Dissection (ESD)?

He mea maʻalahi loa kēia e hoʻomaopopo. Ua lohe paha ʻoe i kahi hoʻāʻo ' endoscopy '. He kaʻina hana kahi e hoʻokomo ʻia ai kahi ʻōmole palupalu me kahi kāmela ma o ka waha a i ʻole ka anus e nānā i ka paipu meaʻai . ʻO ia ka mea like. Akā he ʻoi aku ka holomua.

Ma ka ESD, hoʻohana kahi gastroenterologist i kahi endoscope e hoʻokomo i nā mea hana ʻoki kino maikaʻi loa. A laila, ʻoki pono ʻia a wehe ʻia nā ʻiʻo ʻē i loko o ka paia o kou ʻōnaehana ʻai, ka ʻāpana e like me ka puʻupuʻu . ʻO ka mea maikaʻi loa, ʻo ia ka hana ʻana o kēia mau mea a pau me ka ʻole o ka hana ʻana i kekahi ʻoki ma waho o kou kino. ʻO ke ʻano kēia, ʻoi aku ka liʻiliʻi o ka ʻeha ma mua o ka hana ʻoki nui ʻana, a hiki iā ʻoe ke hoʻōla wikiwiki.

He aha nā ʻano kūlana e pono ai ke ʻano ESD?

Hoʻohana pinepine ʻia kēia lāʻau lapaʻau e wehe i nā ulu ʻana o ka maʻi kanesa a i ʻole precancerous, polyps , a i ʻole nā ​​​​​​lesions i loko o ke ala ʻai. He kūpono loa ka ESD no nā kūlana ma lalo nei:

• ʻO ka esophagus a Barrett : Ma kēia kūlana, loli nā pūnaewele ma ka ʻaoʻao haʻahaʻa o ka esophagus i ke ʻano ʻē. Hiki i kēia mau mea ke lilo i kanesa ma hope.
• Ka maʻi ʻaʻai colorectal
• Ka maʻi ʻaʻai ʻōpū
• Ka maʻi ʻōpū liʻiliʻi
• Ka maʻi ʻōpū

He aha ka ʻokoʻa ma waena o ESD a me EMR?

Ua lohe paha ʻoe i kekahi hana ʻē aʻe i kapa ʻia ʻo 'Endoscopic Mucosal Resection (EMR).' ʻO kēia mau hana ʻelua he mau hana minimally invasive i hana ʻia me ka hoʻohana ʻana i ka endoscope. Eia nō naʻe, aia kekahi mau ʻokoʻa iki ma waena o nā mea ʻelua. E nānā kākou i ke ʻano o lākou.

Pehea ʻoe e hoʻomākaukau ai ma mua o ka mālama ʻana?

ʻAʻole pono kēia i ka hoʻomākaukau nui. E hāʻawi kāu kauka iā ʻoe i nā kuhikuhi pololei āu e pono ai.

• Inā e hoʻokomo ʻia ana ka endoscope ma ka waha (e.g. ʻōpū, esophagus): E noi ʻia ʻoe e kāohi i ka ʻai ʻana a i ʻole ka inu ʻana no kekahi mau hola ma mua o ka mālama ʻana.
• Inā hoʻokomo ʻia ma ke ʻano rectal (e.g., i loko o ka colon): E noi ʻia ʻoe e "hoʻomākaukau i ka bowel." ʻO ke ʻano kēia, pono ʻoe e lawe i kahi laxative a kāu kauka e kuhikuhi ai e hoʻomaʻemaʻe loa i kāu colon. E ʻae kēia i ke kauka e ʻike maopopo i loko o kou colon.

He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?

ʻAʻohe pono e hopohopo no kēia. E hoʻomoe loa kekahi kauka anesthesiologist iā ʻoe ('General Anesthesia'), a i ʻole e hāʻawi iā ʻoe i ka lāʻau lapaʻau e hoʻomaha ai a ʻeha ʻole. ʻAʻole ʻoe e manaʻo i kekahi mea i kēia manawa.

I ka wā o ka mālama ʻana, e hahai ke kauka i kēia mau hana:

1. Hoʻokomo ʻia ka ʻōmole endoscope ma o ka waha a i ʻole ka rectum.

2. Ke nānā nei ma o ke kāmela, e hele i kahi o kēlā puʻupuʻu ʻē.

3. Ua hōʻailona ʻia kahi o ka puʻupuʻu me kahi mea hana kūikawā.

4. I mea e pale aku ai i ka hōʻino ʻana i nā ʻiʻo olakino ma lalo o ka puʻupuʻu, ua hoʻokomo ʻia kahi wai kūikawā ma lalo o ka puʻupuʻu. Hoʻokumu kēia i kahi "cushion" ma lalo o ka puʻupuʻu, e hāpai ana i ka puʻupuʻu i luna.

5. A laila, me ka hoʻohana ʻana i ka pahi uila alapine kiʻekiʻe, ua ʻoki loa ʻia a wehe ʻia ka puʻupuʻu.

Hiki i kēia kaʻina hana holoʻokoʻa ke hala ma kahi o hoʻokahi a ʻekolu hola.

He aha ka mea e hana ʻia ma hope o ka mālama ʻana? A he aha nā pilikia?

Ma hope o ka lāʻau lapaʻau, e nānā ʻia ʻoe i loko o kahi lumi hoʻōla a hiki i kou ala ʻana mai ka anesthesia. Hoʻouna ʻia ka ʻiʻo i lawe ʻia i kahi keʻena hoʻokolohua no ka hōʻoia ʻana. Ma laila, nānā kahi pathologist iā ia e ʻike inā he mau hunaola kanesa a inā ua wehe ʻia ke kanesa āpau.

Hiki paha iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi, a i ʻole pono ʻoe e noho i ka haukapila i ka pō. ʻO ka mea nui loa, he 24 mau hola ka hala ʻana o nā hopena o ka anesthesia, no laila pono ʻoe e hele pū me kekahi a hoʻokele iā lākou i ka home ma ke kaʻa.

Loaʻa paha kahi ʻeha iki no hoʻokahi a ʻelua paha lā ma hope o ka lāʻau lapaʻau, akā aia kekahi mau mea āu e makaʻala ai.

He mea kākaʻikahi nā pilikia o ka ESD, akā hiki iā lākou ke komo pū me ke kahe ʻana o ke koko, ka perforation gastrointestinal, a i ʻole nā ​​​​​​ʻoʻoleʻa esophageal. He mea kākaʻikahi loa kēia.

ʻEhia ka lōʻihi e hoʻōla ai?

Hiki i ka hapa nui o ka poʻe ke hoʻi i kā lākou hana maʻamau ma hope o 5 mau lā. Eia nō naʻe, inā he hana koʻikoʻi kou kino, hiki i kāu kauka ke aʻo iā ʻoe e hoʻomaha no kekahi manawa. Hiki ke ʻano ʻē iki kou neʻe ʻana o ka ʻōpū no hoʻokahi pule ma hope o ka mālama ʻana.

E noi ʻia ʻoe e ʻike hou i ke kauka ma kahi o ʻelua pule ma hope o ka mālama ʻana. A laila hiki iā ʻoe ke kūkākūkā i nā hopena o ka hōʻike lab a inā pono ʻoe i ka mālama hou aku.